There’s no question that the COVID-19 pandemic has amplified the stress and anxiety in our lives. And managing those emotions has driven more Americans to substance use.
Thirteen percent of Americans reported starting or increasing substance use as a way to cope with COVID-19, according to one survey.
And more than 100,000 Americans died of overdoses in the first 12 months of the pandemic, up almost 30% over the year before, according to the National Center for Health Statistics.
“We were in the middle of a national emergency with overdoses before COVID-19, and now things have only gotten worse,” says Gail Basch, MD, a psychiatrist at Rush.
“As providers, we are concerned about social isolation and pandemic-related stress contributing to substance use,” she adds. “Stress, trauma and mental illness make people more vulnerable to developing substance use disorders and make pre-existing substance use worse, and COVID-19 is a big concern for this group.”
Substance use and isolation
Isolation has been a key aspect of COVID-19 for many Americans. “And with isolation comes more drinking and more smoking, and for that matter, more of anything that may be not be the best for us,” Basch says.
One study found that alcohol and tobacco sales spiked during the first months of the pandemic: 34% for alcoholic beverages and 13% for tobacco.
We tend to forget that some of the deadliest substances are tobacco and alcohol, and those were, and still are, more readily available.
Basch notes that early in the pandemic, people were cut off from their support systems, which also contributed to the increase in substance use.
“Family, friends and medical treatment are critical for mental and physical health,” she says. “And for people already in treatment, they are now faced with more challenges during the pandemic. For example, lifelines to individual and group treatment, as well as access to life-saving medications, such as buprenorphine and methadone.”
Substance users are more vulnerable than ever due to COVID-19: They’re more likely to catch it and are at an increased risk of severe illness, slowness of recovery and death from COVID-19, the CDC suggests.
“The pandemic puts many at risk, including those with a history of mental illness and substance use, as well as those with no history, such as younger adults, racial and ethnic minorities, essential workers and unpaid adult caregivers,” Basch says.
For young adults who engage in substance use, research shows that 15% of high school students reported using cocaine, heroin or ecstasy, and 14% of students reported misusing opioids.
“When you're talking about young adults, you're talking about developing brains,” Basch says. “And a young adult in isolation on a daily basis is a set-up for disaster.”
Studies also suggest there has been a surge in deaths due to opioid use and overdoses in communities of color in recent years.
“Underserved communities have taken an even harder hit during the pandemic,” Basch says. “COVID-19 put a magnifying lens on a problem that already existed.”
Coping during a difficult time
Basch recommends following the acronym HALT, which stands for hungry, angry, lonely and tired.
“Are you too hungry? Are you angry? Are you lonely? Are you tired?” she says. “If you can start to realize your needs, you can try and cope with them in a way other than substance use and unhealthy behaviors.”
Basch offers this advice:
- Engage in regular exercise
- Eat healthy food
- Get sunlight
- Create a new routine
- Join a virtual peer group
- Reach out to a family member or friend or faith leader
- Write down your thoughts or use a gratitude journal
- Discuss your behaviors and questions with a medical professional
If a family member or friend is hesitant to get help, Basch says the first step is approaching them with an open conversation.
“Talk to your family member or friend and say in a nonconfrontational way, ‘I'm concerned about you, and here's what I've noticed,’” she says. “Often that conversation can be met with resistance, but that doesn't mean you shouldn't have the conversation — or more than once. Everyone is different, so be sure to find the approach that works best for you and your loved one.”
Hope for the future
Despite the increase in substance use, Basch feels hopeful for the future due to progress in recognizing and treating these diseases, as well as a decrease in stigma.
“People are more open to reaching out for help,” she says. “The earlier the help the better. The notion of rock bottom is outdated; things change once treatment — including virtual care options — is received. Our addiction medicine team at Rush is ready to help.”